The PACT-21 CASSANDRA study is a randomized, open-label, 2 × 2 factorial phase 3 study that compared preoperative mFOLFIRINOX with PAXG in patients with stage I–III resectable or borderline resectable pancreatic ductal adenocarcinoma (PDAC). The results of the first randomized analysis showed that PAXG significantly improved recurrence-free survival (EFS) compared with mFOLFIRINOX. Preoperative PAXG is considered the standard treatment option for resectable or borderline resectable PDAC. Accordingly, preoperative PAXG should serve as a standard comparison group for future studies in this setting.